Defining the type-2 diabetic population: a first step to understanding the impact of pathway choices

Strategic Insight reports are designed to support strategic objectives and planning by Integrated Care System leaders. The aim of this report is to determine current prescribing patterns and prescribing costs of antidiabetic treatments across the ICBs in the North of England with a particular emphasis on SGLT-2 inhibitors and GLP-1 mimetics. This will enable organisations to audit current practices against updated NICE guideline recommendations, and to estimate the financial and resource implications of prescribing SGLT-2s to a wider population.

A forthcoming addendum to this publication will estimate the gap between current prescribing of SGLT-2 inhibitors and the number of people with type 2 diabetes who are estimated to be eligible for treatment. Three versions of this addendum will be published covering the North East and Cumbria, Greater Manchester, and Yorkshire and the Humber regions.

Drugs used in Diabetes

Overview

This report looks at prescribing trends in primary care for Drugs used in Diabetes at SICBl and ICB level with particular focus on insulins, anti-diabetic drugs and diagnostic & monitoring devices. Prescribing data is weighted with QoF registers, and also uses HES data to measure prescribing to outcomes.

If you have any queries about the content of the report please contact us at nuth.nyrdtc.rxsupp@nhs.net

Frequency

Quarterly

Data Period

April 2020 to March 2023

Budget impact of metformin 1g immediate release tablet prescribing

The purpose of this bulletin is to highlight the rapid increase in price of metformin 1g tablets over the last year, and to raise awareness of the difference in price of metformin 1g immediate release (IR) tablets compared with 500mg IR tablets. It considers the potential budget impact to primary care of prescribing metformin 1g IR tablets across the ICSs in the North East & Yorkshire region and Greater Manchester.

Formulary assessment – Glucagon (Ogluo)

Formulary assessment tools are templates to support local decision making. They list NICE guidance, MHRA safety advice, and other relevant high quality advice and guidelines relevant to making decisions for local formularies.

The templates are pre-populated with useful information to reduce duplication of effort, with space for the addition of local information as appropriate. The purpose of the document is to support consistent decision making by formulary groups and APCs.

This information is produced for use by NHS healthcare professionals and RDTC stakeholders.

Comparison of DPP-4 inhibitors (Gliptins)

Comparison documents are designed to support prescribers and medicines management teams to maximise health gains through the optimum use of medicines within a specific therapeutic area.

There are currently five dipeptidyl peptidase-4 (DPP-4) inhibitors (or gliptins) available in the UK for the management of type 2 diabetes mellitus. There are a number of differences between the DPP-4 inhibitors in terms of licensing, interactions, renal impairment dose adjustment, hepatic impairment dose adjustment, and cost. This comparison table allows prescribers and other healthcare professionals to easily compare the characteristics of these medicines.

Insulin aspart Sanofi (Trurapi): Biosimilar Insulin Aspart

Overview

Evaluation reports aim to give objective information and guidance on medicines and medical devices to commissioners of health services, prescribers and others. They include efficacy, adverse effects, place in treatment and arrangements for prescribing.

Insulin aspart Sanofi (Trurapi®▼) is the first biosimilar of insulin aspart (NovoRapid®). It is licensed for the treatment of diabetes mellitus in adults, adolescents, and children aged >1 year. This publication reviews its efficacy and safety, and the limitations of the evidence.

Fast acting insulin lispro for the treatment of diabetes mellitus

Overview

New Drug Evaluations are concise, structured reviews of new drugs recently launched within the NHS. These documents seek to provide a brief overview of the efficacy, safety and cost of new drugs.

Ultra-rapid acting insulin lispro (Lyumjev®▼, Lilly) is a new formulation of insulin lispro with added treprostinil and citrate to produce a more rapid onset of action. It is the second ultra-rapid acting insulin analogue to be launched after Fiasp®▼.

Download the full review below to read more.

NICE has accredited the process used by the Regional Drug and Therapeutics Centre to produce New Drug Evaluations. Accreditation is valid until the 31st of December 2023.
For more information visit www.nice.org/accreditation

Cardiovascular outcomes associated with SGLT2 inhibitors (update 2)

Overview

Medicines in Practice is a series of evidence–based publications specifically designed to support stakeholder medicines optimisation services. The series aims to maximise health gains through the optimum use of medicines, by influencing and changing prescribing behaviour.

The sodium-glucose co-transporter 2 (SGLT2) inhibitors canagliflozin, dapagliflozin, empagliflozin and ertugliflozin are licensed for the improvement of glycaemic control in adults with type 2 diabetes, a population at increased risk of cardiovascular events. Recent clinical trials and cohort studies have assessed whether the SGLT2 inhibitors reduce this risk.

Download the full review below to read more.

Cardiovascular outcomes associated with GLP1 receptor agonists (updated)

Overview

Medicines in Practice is a series of evidence–based publications specifically designed to support stakeholder medicines optimisation services. The series aims to maximise health gains through the optimum use of medicines, by influencing and changing prescribing behaviour.

The glucagon-like peptide 1 receptor agonists (GLP1RAs) dulaglutide, exenatide, liraglutide, lixisenatide, and semaglutide are licensed for the improvement of glycaemic control in adults with type 2 diabetes, a population which is also at increased risk of cardiovascular events. Good quality evidence assessed the effect of these drugs on cardiovascular outcomes.

Download the full review below to read more.

Flash glucose monitoring prescribing update – Freestyle Libre

Prescribing for Population Health (PPH) is an ongoing series that aims to support ICSs to improve the health of the populations they serve. PPHs use prescribing data, biomedical literature and other data sources to provide new insights.

This publication highlights the variation in flash glucose monitoring prescribing, specifically Freestyle Libre, in people with Type 1 diabetes mellitus (T1DM). Prescribing is considered both in terms of the percentage of unique people prescribed this type of monitoring system and also the prescribing volume in 19/20 relative to the NHS England (NHSE) National funding arrangements.

Estimated avoidance of hospital admissions attributable to FL prescribing has also been quantified in terms of frequency and cost, and reduction in blood glucose test strips has been estimated.

There are three versions of this publication; please select the appropriate version for your region below.